AWARD NOMINATION FORM
Australia Day 2019
ENQUIRIES AND NOMINATION FORMS TO:
Renmark Paringa Council –
PO Box 730
61 Eighteenth Street, Renmark SA 5341
Phone: 08 8580 3000
Fax: 08 8580 3030
Email:
OVERVIEW:
Do you know someone who makes our community a better place?
The Citizen of the Year Awards reward and recognise individuals and organisations that have made a noteworthy contribution during the current year, and/or given an outstanding service over a number of years, to the local community over and above normal employment duties.
Outstanding contribution and community service includes areas such as education, health, fundraising, charitable and voluntary services, business, sport, arts, the environment, or any other area that contributes to the advancement and well being of our community.
Nominate someone who makes a real difference in our community and give them the opportunity to be rewarded and recognised for their important contribution.
PROCEDURE:
Visit our website download the nomination form.
All enquiries can be directed to Council’s Community Development Department.
How to get your nomination form to Council:
Post:Renmark Paringa Council, PO Box 730, Renmark SA 5341
Deliver:Renmark Paringa Community & Civic Centre,
61 Eighteenth Street, Renmark SA 5341
Email:
If required, additional material may be attached to your nomination.
NOMINATIONS CLOSE AT 5PM FRIDAY 7 DECEMBER 2018
Categories:
Citizen of the Year Award: To be eligible, the person must be an Australian Citizen and the person must either live in the Renmark Paringa Council area or if residing out of the area, the services they provide are for the Renmark Paringa Council area.
Young Citizen of the Year Award: To be eligible, the person must be an Australian Citizen under 30 years of age on 26 January 2019 and the person must either live in the Renmark Paringa Council area or if residing out of the area, the services they provide are for the Renmark Paringa Council area.
Community Event of the Year Award: This is presented to the person/group who has staged the most outstanding community event during the past year (2018). The event must have been held in the Renmark Paringa Council area or have resulted in a significant benefit to the Renmark Paringa area.
Consideration is given, but not limited to, the following Selection Criteria:
Citizen and Young Citizen of the Year
- Number of different groups the applicant has being a member of/involved in.
- Total number of years support has been provided to all groups involved in/length of service to the Renmark/Paringa/Lyrup communities.
- Types of groups involved in eg sporting clubs; service clubs; environmental groups; heritage; health and/or disability groups; general community groups; education services eg schools, pre-schools, childcare; aged services etc.
- Contribution to the groups they have been involved in – what have they done to assist the groups, roles played etc.
- What have their achievements been as an individual as well as part of a group.
- Have they been recognised by the group they are involved in or others eg previous awards/recognition.
- Benefit of event to the community.
- Number of people involved in the organisation and running of the event (paid staff, volunteers or a mixture of both).
- Number of attendees at event.
- Number of years the event has been running.
- How the event has grown (if held in previous years) eg increase of numbers attending, more activities offered as part of the event, event held for a longer time or more days etc.
SECTION 1: NOMINEE DETAILS (the person/organisation you would like to nominate)
Please provide as much information as possible – leave blank any questions that don’t apply.
AWARD CATEGORY: (please tick)
Citizen: / Young Citizen: / Community Event:
Name of Person or
Event:
Residential & Postal
Address of Person/Event:
Contact Telephone of Person/Event:
Email Address of
Person/Event:
Date of Birth (Citizen and
Young Citizen only):
Is the person being
nominated an Australian
Citizen? (Citizen and
Young Citizen only)
If you ticked ‘NO’, the
person is ineligible / YES: / NO:
Reason for nomination –
how has the person/event
contributed to the
Community? (refer to
selection criteria on page
2)
Please list any other
significant contributions
and/or achievements:
SECTION 2: NOMINATOR (your details)
Your Name:
Your Address:
Your Contact Phone:
Your Email:
SECTION 3: OFFICE USE ONLY
Date Received:
Incoming Mail
Registration Number:
Date nominator notified of
outcome of application: